The Virginia Institute for Marital & Family Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

72405001 Issued in VA

Legal business name

THE VIRGINIA INSTITUTE FOR MARITAL & FAMILY THERAPY

Practice address

13911 St Francis Blvd
Suite 106
Midlothian, VA 23114

Phone

(804) 365-8555

Fax

(804) 365-8575

NPI assigned

Jul 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce Sanford Evans, LMFT LPC CSAC NCC

Title

Owner

Phone

(804) 365-8555

Specialties & licenses 2

Addresses

Other names 1

• The Virginia Institute for Systemic Treatment Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1497760193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13911 ST FRANCIS BLVD",
            "address_2": "SUITE 106",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-365-8555",
            "fax_number": "804-365-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 ST FRANCIS BLVD",
            "address_2": "SUITE 106",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-365-8555",
            "fax_number": "804-365-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VIRGINIA INSTITUTE FOR MARITAL & FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "SANFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-365-8555",
        "authorized_official_credential": "LMFT LPC CSAC NCC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000980",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "72405001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Virginia Institute for Systemic Treatment",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.